Skip to main content
Log in

The effect of CPAP therapy on excessive daytime sleepiness and quality of life in subjects with obstructive sleep apnoea: an AB design study

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Background

Obstructive sleep apnoea (OSA) is a disorder characterized by apnoeas and hypopnoeas due to repetitive upper airway collapse during sleep. So far, there are no published data regarding quality of life (QoL) and adherence to CPAP among patients with OSA in India. This study aims to measure sleepiness and QoL of patients before and after effective CPAP use in patients with OSA.

Method

Newly diagnosed subjects with OSA were included, and socio-demographic risk factors and anthropomorphic measures were collected. Epworth sleepiness scale (ESS) and short sleep apnoea quality of life index (SAQLI) were administered before and after a minimum of 4 weeks of domiciliary CPAP use. While short SAQLI is a disease-specific questionnaire, ESS measures excessive daytime sleepiness.

Results

In 92 subjects age range was 28–74 years, mean age 49.7 ± 11.3 years, and male:female ratio was 70:22. Mean BMI was 32.1 ± 6.4 kg/sq.m; mean neck circumference was 39.4 ± 3.4 cm; 56 subjects had Mallampati score of 3 or 4. One-month follow-up was completed by 34 subjects who reported a mean of 5.8 ± 1.1 hours/night usage of CPAP. Mean ESS score was 11.31 ± 5.6 at baseline vs 6.9 ± 3.3 after 1 month (p = 0.02), and baseline short SAQLI score was at 2.54 ± 1.26 vs 1.38 ± 0.87 after 1 month (p = 0.0001).

Conclusions

Subjects reported adequate compliance with CPAP at 1 month, and both ESS and short SAQLI showed a significant improvement in these patients. CPAP compliance improved both QoL and sleepiness in patients with OSA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Kryger MH, Dement WC, Roth T (2017) Principles and practice of sleep medicine, 6th edn. Elsevier Inc, Philadelphia

    Google Scholar 

  2. Young T, Gottlieb DJ, PEP (2002) Epidemiology of Obstructive Sleep Apnea. Am J Resp Crit Care Med 165:1217–1239

    Article  Google Scholar 

  3. Nickerson J, Lee E, Nedelman M, Aurora RN, Krieger A, Horowitz CR (2015) Feasibility of Portable Sleep Monitors to Detect Obstructive Sleep Apnea (OSA) in a Vulnerable Urban Population HHS Public Access. J Am Board Fam Med 28:257–264. https://doi.org/10.3122/jabfm.2015.02.140273

    Article  PubMed  PubMed Central  Google Scholar 

  4. Burgess KR, Havryk A, Newton S et al (2013) Targeted case finding for OSA within the primary care setting. J Clin Sleep Med 9:681–686. https://doi.org/10.5664/jcsm.2838

  5. Udwadia ZF, Doshi AV, Lonkar SG, Singh CI (2004) Prevalence of Sleep-disordered Breathing and Sleep Apnea in Middle-aged Urban Indian Men. Am J Respir Crit Care Med 169:168–173. https://doi.org/10.1164/rccm.200302-265OC

    Article  PubMed  Google Scholar 

  6. Reddy EV, Kadhiravan T, Mishra HK, Sreenivas V, Handa KK, Sinha S, Sharma SK (2009) Prevalence and risk factors of obstructive sleep apnea among middle-aged urban Indians: A community-based study. Sleep Med 10:913–918. https://doi.org/10.1016/j.sleep.2008.08.011

    Article  PubMed  Google Scholar 

  7. Parish JM, Shepard JW Jr, Shepard JW (1990) Cardiovascular effects of sleep disorders. Chest 97:1220–1226

    Article  CAS  Google Scholar 

  8. Bucks RS, Olaithe M, Eastwood P (2013) Neurocognitive function in obstructive sleep apnoea: A meta-review. Respirology 18:61–70. https://doi.org/10.1111/j.1440-1843.2012.02255.x

    Article  PubMed  Google Scholar 

  9. Pascual M, de Batlle J, Barbé F et al (2018) Erectile dysfunction in obstructive sleep apnea patients: A randomized trial on the effects of Continuous Positive Airway Pressure (CPAP). PLoS One 13(8):1–13. https://doi.org/10.1371/journal.pone.0201930

    Article  CAS  Google Scholar 

  10. Yang EH, Hla KM, McHorney CA et al (2000) Sleep apnea and quality of life. Sleep 23:535–541

    Article  CAS  Google Scholar 

  11. Batool-Anwar S, Goodwin JL, Drescher AA et al (2014) Impact of CPAP on activity patterns and diet in patients with obstructive sleep apnea (OSA). J Clin Sleep Med 10:465–472. https://doi.org/10.5664/jcsm.3686

    Article  PubMed  PubMed Central  Google Scholar 

  12. Weaver TE, Grunstein RR (2008) Adherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment. Proc Am Thorac Soc 5:173–178. https://doi.org/10.1513/pats.200708-119MG

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kawahara S, Akashiba T, Akahoshi T, Horie T (2005) Nasal CPAP improves the quality of life and lessens the depressive symptoms in patients with obstructive sleep apnea syndrome. Intern Med 44:422–427

    Article  Google Scholar 

  14. Siccoli MM, Pepperell JC, Kohler M et al (2008) Effects of continuous positive airway pressure on quality of life in patients with moderate to severe obstructive sleep apnea: data from a randomized controlled trial. Sleep 31:1551–1558

    Article  Google Scholar 

  15. Dutt N, Janmeja AK, Mohapatra PR, Singh AK (2013) Quality of life impairment in patients of obstructive sleep apnea and its relation with the severity of disease. Lung India 30:289–294. https://doi.org/10.4103/0970-2113.120603

    Article  PubMed  PubMed Central  Google Scholar 

  16. Battan G (2016) Effect of CPAP Therapy in improving daytime sleepiness in moderate and severe OSA. J Clin Diagnostic Res 10(11):OC14–OC16. https://doi.org/10.7860/JCDR/2016/23800.8876

  17. Dutt N, Chaudhry K (2016) Health related quality of life in adult obstructive sleep apnea. J Sleep Disord Ther 05:2. https://doi.org/10.4172/2167-0277.1000234

    Article  Google Scholar 

  18. Kang HH, Kang JY, Ha JH, Lee J, Kim SK, Moon HS, Lee SH (2014) The Associations between anthropometric indices and obstructive sleep apnea in a Korean population. PLoS One 9:1–12. https://doi.org/10.1371/journal.pone.0114463

    Article  CAS  Google Scholar 

  19. Kim SE, Park BS, Park SH, Shin KJ, Ha SY, Park JS, Park KM (2015) Predictors for presence and severity of obstructive sleep apnea in snoring patients: significance of neck circumference. J Sleep Med 12:34–38

    Article  Google Scholar 

  20. Devaraj U, Rajagopala S, Kumar A, Ramachandran P, Devereaux PJ, D'Souza GA (2017) Undiagnosed obstructive sleep apnea and postoperative outcomes: A prospective observational study. Respiration 94:18–25. https://doi.org/10.1159/000470914

    Article  PubMed  Google Scholar 

  21. Lee W, Lee S-A, Ryu HU et al (2016) Quality of life in patients with obstructive sleep apnea: Relationship with daytime sleepiness, sleep quality, depression, and apnea severity. Chron Respir Dis 13:33–39. https://doi.org/10.1177/1479972315606312

    Article  PubMed  Google Scholar 

  22. Coman AC, Borzan C, Vesa CS, Todea DA (2016) Obstructive sleep apnea syndrome and the quality of life. Clujul Med 89:390–395. https://doi.org/10.15386/cjmed-593

    Article  PubMed  PubMed Central  Google Scholar 

  23. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG (2019) Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 15:335–343. https://doi.org/10.5664/jcsm.7640

    Article  PubMed  PubMed Central  Google Scholar 

  24. Morsy NE, Farrag NS, Zaki NFW, Badawy AY, Abdelhafez SA, el-Gilany AH, el Shafey MM, Pandi-Perumal SR, Spence DW, BaHammam AS (2019) Obstructive sleep apnea: Personal, societal, public health, and legal implications. Rev Environ Health 34:153–169. https://doi.org/10.1515/reveh-2018-0068

    Article  PubMed  Google Scholar 

  25. Baron KG, Smith TW, Czajkowski LA, Gunn HE, Jones CR (2009) Relationship quality and cpap adherence in patients with obstructive sleep apnea. Behav Sleep Med 7:22–36. https://doi.org/10.1080/15402000802577751

    Article  PubMed  Google Scholar 

  26. Diamanti C, Manali E, Ginieri-Coccossis M, Vougas K, Cholidou K, Markozannes E, Bakakos P, Liappas I, Alchanatis M (2013) Depression, physical activity, energy consumption, and quality of life in OSA patients before and after CPAP treatment. Sleep Breath 17:1159–1168. https://doi.org/10.1007/s11325-013-0815-6

    Article  CAS  PubMed  Google Scholar 

  27. Calik MW (2016) Treatments for obstructive sleep apnea. J Clin Outcomes Manag 23:181–192

    PubMed  PubMed Central  Google Scholar 

  28. Calik Michael W (2016) Treatments for Obstructive Sleep Apnea. J Clin Outcomes Manag. 23(4):181–192

    PubMed  PubMed Central  Google Scholar 

  29. Timkova V, Nagyova I, Reijneveld SA, Tkacova R, van Dijk JP, Bültmann U (2020) Quality of life of obstructive sleep apnoea patients receiving continuous positive airway pressure treatment: A systematic review and meta-analysis. Hear Lung 49:10–24. https://doi.org/10.1016/j.hrtlng.2019.10.004

    Article  Google Scholar 

  30. Lacasse Y, Bureau MP, Sériès F (2004) A new standardised and self-administered quality of life questionnaire specific to obstructive sleep apnoea. Thorax 59:494–499. https://doi.org/10.1136/thx.2003.011205

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. D’Ambrosio C, Bowman T, Mohsenin V (1999) Quality of life in patients with obstructive sleep apnea: Effect of nasal continuous positive airway pressure - A prospective study. Chest 115:123–129. https://doi.org/10.1378/chest.115.1.123

    Article  PubMed  Google Scholar 

  32. Silva GE, Goodwin JL, Vana KD, Quan SF (2016) Obstructive sleep apnea and quality of life: comparison of the SAQLI, FOSQ, and SF-36 Questionnaires. Southwest J Pulm Crit Care 13:137–149. https://doi.org/10.13175/swjpcc082-16

  33. Silva GE, An M-W, Goodwin JL et al (2009) LongitudinAl evaluation of sleep-disordered breathing and sleep symptoms with change in quality of life: the sleep heart health study (SHHS). Sleep 32(8):1049–1057

    Article  Google Scholar 

  34. Flemons WW, Reimer MA (2002) Measurement properties of the Calgary sleep apnea quality of life index. Am J Respir Crit Care Med 165:159–164. https://doi.org/10.1164/ajrccm.165.2.2010008

    Article  PubMed  Google Scholar 

  35. Flemons WW, Reimer MA (1998) Development of a Disease-specific Health-related Quality of Life Questionnaire for Sleep Apnea. Am J Respir Crit Care Med 158:494–503

    Article  CAS  Google Scholar 

  36. Batool-Anwar S, Goodwin JL, Kushida CA, Walsh JA, Simon RD, Nichols DA, Quan SF (2016) Impact of continuous positive airway pressure (CPAP) on quality of life in patients with obstructive sleep apnea (OSA). J Sleep Res 25:731–738. https://doi.org/10.1111/jsr.12430

    Article  PubMed  PubMed Central  Google Scholar 

  37. Goel AK, Talwar D, Jain SK (2015) Evaluation of short-term use of nocturnal nasal continuous positive airway pressure for a clinical profile and exercise capacity in adult patients with obstructive sleep apnea-hypopnea syndrome. Lung India 32:225–232. https://doi.org/10.4103/0970-2113.156226

    Article  PubMed  PubMed Central  Google Scholar 

  38. Patel SR, White DP, Malhotra A, Stanchina ML, Ayas NT (2003) Continuous positive airway pressure therapy for treating sleepiness in a diverse population with obstructive sleep apnea results of a meta-analysis. Arch Intern Med 163:565–571. https://doi.org/10.1001/archinte.163.5.565

    Article  PubMed  Google Scholar 

  39. Tamanna S, Geraci SA (2013) Major sleep disorders among women: (Women’s health series). South. Med. J. 106:470–478

    Article  Google Scholar 

  40. Chervin RD (2000) Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea. Chest 118:372–379. https://doi.org/10.1378/chest.118.2.372

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Uma Devaraj.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Venkatnarayan, K., Devaraj, U., Veluthat, C. et al. The effect of CPAP therapy on excessive daytime sleepiness and quality of life in subjects with obstructive sleep apnoea: an AB design study. Sleep Breath 25, 1351–1357 (2021). https://doi.org/10.1007/s11325-020-02237-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-020-02237-4

Keywords

Navigation